How to Make Healthy Decisions Under High Pressure & Anxiety

In this podcast (episode #334) and blog, I speak about the link between anxiety, stress, and decision-making.

Often, when we are in an anxious state, we cannot seem to make a decision, or, if we do, we end up making a choice we regret. I know this has happened to me many times! 

What should we do when this happens? Is there a way out of this mental swamp? Thankfully, yes!  

To make healthy decisions, our brain needs optimal blood, oxygen and energy flow, especially in the front of the brain (the frontal lobe). When we are in toxic stress, this flow is constricted, which can impact how and what we choose to say or do in the moment, as well as our overall wellbeing. 

However, we can learn how to make our stress work for us instead of against us. The key point here is to see our anxiety as a signal telling us something is going on in our lives that needs to be addressed.  

Anxiety is not something we should suppress or ignore. It is designed to get our attention in a focused way, so we can deal with the disequilibrium we are experiencing in our life. If we ignore this signal, it can affect our wellbeing, putting us in a toxic stress state that can impact our ability to make decisions and increase our impulsivity. It can also impact our mental and physical health due to the mind-brain-body connection (known as psychoneurobiology). 

We need to learn how to tune into these signals and manage them before they take over our thinking. This includes nothing our unique red flags: how anxiety and stress show up in our life, how we feel emotionally and physically, and how we can manage these signals to make healthy decisions. 

Self-regulation is key! When we make a decision, we should try to get into the habit of observing ourselves. Why did we choose this? What impacted our choice? Why did we feel this way? How did this impact our ability to decide? One way I like to do this is by practicing pausing just before I make a decision. During this pause, I breathe in deeply for 3 counts, and breathe out for 7 counts, and do this a few times depending on how I feel and how important the choice I am about to make is. As I do this, I am better able to observe what I feel in the moment because I am getting my neurophysiology under control, which, in turn, helps me better understand my anxiety signals and stress state, bringing back balance into my brain so I can make a good decision. This really is a great way to calm down the mind when things are difficult!  

If, after doing this, you still feel you need more time and information (as often happens with really big decisions), this is totally okay! Just say you need more time to think about it (if possible)—never be ashamed of needing more time or asking for more space to think something through.  

If you feel a lack of confidence in the moment, remind yourself of all the times you made a good choice in the past. Give yourself a little pep talk: remember when you made a choice under pressure and managed to successfully overcome a challenge. 

If you still feel stuck, work on what I call the “possibilities mindset”.  Think of all the possibilities in each situation. How will this choice play out? How did this play out in the past? What if you made a different choice? What if this happened? What have you learned? This is a great brain exercise and a reminder that life isn’t linear—we can never truly grasp all the threads that lead us to where we are, or where we will be.  

If you are not sure how to do this, use the 5-step mind management system I developed based on my clinical practice and research, called the Neurocycle (for more on this, check out my latest book Cleaning Up Your Mental Mess and my app Neurocycle). First, gather awareness of the information you need and your past choices. What is the data telling you? What worked? What didn’t? Now, reconceptualize all “failures” as “I haven’t failed; I have learned x things that now I know don’t work, which is great to know!” Reflect on what these lessons are by asking, answering, and discussing them to find the information, emotions, and physical responses in your brain and body. Write down what you have been reflecting on, in as much detail as possible, to help organize your thinking. Then, recheck what you have written to add more insight and look for patterns. Now, practice looking at what you have written and use it to make good choices. During this time, watch how this carries over into your day-to-day life; observe and write how this mental exercise helps you, especially during tough times.  

For more on managing anxiety, stress and decision-making, listen to my podcast (episode #334). If you enjoy listening to my podcast, please consider leaving a 5-star review and subscribing. And keep sharing episodes with friends and family and on social media. (Don’t forget to tag me so I can see your posts!).       

To learn more about how to manage your mental health and help others, join me at our 7th Annual Mental Health Solutions Retreat, December 2-4, 2021! The core focus of this conference is to give you simple, practical, applicable, scalable, and scientific solutions to help you take back control of your mental health, help others, and make impactful changes in your community. You will also learn how to manage the day-to-day stressors of life as well as those acute stressors that blindside us. Our goal is to address your most pressing mental health concerns, help you find answers, and equip you with the knowledge and resources you need to make the change from a life of barely surviving to one where you are thriving. Register today at!      

This podcast is sponsored by:

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Podcast Highlights

2:25 The neuroscience of decision-making  

4:00 The difference between good & bad stress in the brain 

4:50 The difference between good & bad anxiety  

8:30 How toxic stress impacts your ability to choose 

11:30 How to make stress & anxiety work for you, not against you 

13:30, 21:00 How to make better choices  

17:00 How to develop a possibilities mindset  

This podcast and blog is for educational purposes only and is not intended as medical advice. We always encourage each person to make the decision that seems best for their situation with the guidance of a medical professional. 

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